Justice Secretary Chris Grayling has described a plan to close an A&E unit as ‘sticking two fingers up’ at local residents – putting him on a collision course with the Health Secretary, Jeremy Hunt.

The emergency ward at Epsom Hospital in Surrey is under threat following a controversial recommendation by NHS officials.

Mr Grayling, the local MP, has vowed to fight the proposals in a move that could trigger a Cabinet row.

Contentious: The Justice Secretary Chris Grayling (left) is on a
collision course with Heath Secretary Jeremy Hunt (right) over the
proposed closure of the A&E unit at Epsom Hospital

He is the second Minister to clash with the Government in a backlash over nationwide closures of casualty units after Iain Duncan Smith, the Work and Pensions Secretary, began a fight to save his local A&E ward at King George Hospital in Ilford, Essex, which may be closed later this year.

Mr Grayling’s intervention comes as Professor Sir Bruce Keogh, NHS medical director, launches a review into how emergency services are organised, warning that the number of closures could accelerate because ‘large-scale reorganisation’ is needed.

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In a strongly worded email, Mr Grayling told constituents last week: ‘It is very obvious that our own local doctors should have the main input in what happens. And yet the provisional recommendations have been put forward without them even having the chance to have their say.

‘I have therefore written to all of our local GPs to ask them their views on the future of Epsom. If a good majority of our local doctors say they want to see changes, we will have to listen to them. But at the moment things seem to be moving ahead without them even having the chance to express their views.’

And he added: ‘I hope the people who are carrying out this review realise today just how much they have effectively stuck two fingers up at Surrey residents in the way that this has started.’

The ‘Better Services, Better Value’ review was originally being carried out into four hospitals in South-West London: St Helier (Sutton), Kingston, Croydon and St George’s (Tooting), but last week South West London NHS said it was being extended to include Epsom.

Proposals include having three hospitals with A&E and maternity units, meaning others could be downgraded or closed. Mr Grayling has claimed some of the financial difficulties at Epsom Hospital have come as a result of losing some services to private providers.

However, his intervention was last night described as ‘hypocrisy’ by Shadow Health spokesman Andrew Gwynne because he backed the Health Bill, which opened up the NHS to competition from the private sector.

Mr Gwynne said: ‘Grayling is not the first Tory Cabinet Minister to be caught out. Now it’s coming home to roost, Ministers might think again about ignoring local concerns and axeing A&E units to save cash.’

Under threat: The entrance to the Accident and Emergency department at Epsom General Hospital

The threat to Epsom brings the total number of A&Es around the country that could be closed or downgraded to 34.

Mr Hunt himself staged a prolonged fight against the closure of his local hospital, the Royal Surrey in Guildford, when it was threatened in 2006.

The campaign, which saw him join a candlelight vigil outside Westminster, was a success.

The latest plans threatening London hospitals mean nine A&Es in the capital now face the axe, leaving questions over how overstretched emergency services will cope.

A London Ambulance Service spokesman said it would need ‘additional funding’ to meet the extra demand caused by changes to the local NHS.

He said: ‘We are facing increasing pressure and we cannot absorb additional demand as a result of changes to local NHS services, particularly the closure of emergency departments. As well as the impact of increased journey times and potential increases in patient handover times at hospital, our experience shows that changes in NHS services can lead to increases in referrals to us from healthcare professionals.’

The regulator, the Care Quality Commission (CQC), has criticised poor staffing levels at the London Ambulance Service, which have contributed to delays in response times for less urgent calls and led to staff training being cancelled.

Figures reveal increasingly long waits for treatment at A&E units

The number of people waiting longer than four hours for treatment in A&E has rocketed by 20 per cent in a year.

More than 600,000 people have spent over four hours waiting during 2012-13 so far – 100,000 more than in the same period the previous year.

Revealing the figures, Shadow Health Secretary Andy Burnham said A&Es units were struggling to cope and ‘suffering from David Cameron’s toxic mix of cuts and reorganisation’.

The Government expects 95 per cent of all people attending A&E to be seen within four hours.

But in the week ending January 13, only 92 per cent of patients were seen within that time frame in major A&E units.

It is the 16th consecutive week that the NHS has missed the target.

A CQC report published last month said: ‘There were not enough qualified, skilled and experienced staff to meet people’s needs.

‘Staffing levels should be reviewed and increased in light of increased demand on the service and to ensure that staff have sufficient time for breaks and training.’

The report also highlighted problems with missing or damaged equipment in ambulances which was putting patients at risk. In one case, a paramedic crew did not have a mechanical suction device when attending to a patient who was choking. In the end a kit was borrowed from other professionals on the scene.

Matthew Hopkins, chief executive for Epsom and St Helier University Hospitals NHS Trust, said: ‘No decisions have been made about which sites will be affected and further work needs to be done to determine whether the recommendations would work in practice.’

A Department of Health spokesman said: ‘We have always been clear about changes to A&E – they are local decisions, they must have support of local clinicians and existing services cannot be withdrawn until new and better arrangements are up and running.’